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1. Brought to you by
How to Provide High Quality, Low
Cost Healthcare
Best Practices And Technologies For Patients,
Businesses and Doctors

2. Thank You to Our Sponsor

3. About the Moderator
Brian McGowan, Ph.D., Moderator, @BrianSMcGowan
Brian S. McGowan, PhD is your host for this series. Dr
McGowan is the Co-Founder and Chief Learning Officer at
ArcheMedX a healthcare informatics and e-learning
technology company. He is the author of '#socialQI: Simple
Solutions for Improving Your Healthcare'. He has lectured
both nationally and internationally on the need to drive
innovation in healthcare. He is currently consulting with
start-up companies, medical societies, patient advocacy
groups, and academic medical centers committed to
accelerate quality improvement through innovative
technology and frictionless information flow.

4. About The Panel
Jason Hwang, M.D., M.B.A., @drjhwang
Jason Hwang, M.D., M.B.A. is an internal medicine physician who, together with Professor
Clayton M. Christensen of Harvard Business School and the late Jerome H. Grossman of
Harvard Kennedy School of Government, co-authored The Innovator's Prescription: A
Disruptive Solution for Health Care (McGraw-Hill, January 2009), the American College of
Healthcare Executives 2010 Book of the Year and recipient of the 2011 Health Service
Journal Circle Prize for Inspiring Innovation. Dr. Hwang previously co-founded and was the
Executive Director of Healthcare at Innosight Institute, a non-profit social innovation think
tank.
Jens Deerberg-Wittram, MD, President, International Consortium for Health Outcomes
Measurement, @ICHOM_Org
Trained as a physician and molecular oncologist, Jens served from 2004 to 2012 as Chief
Executive for a German 15 hospital, 4.800 beds provider organization. He has developed and
implemented valuebased corporate strategy and established a worldwide leading medical
outcomes measurement and reporting system. Prior to working in hospital management, Jens
was a project leader for BCG. He is a Senior Fellow and Faculty Member of the Harvard
Business School and lecturer in executive courses about value-based healthcare delivery.
Dan Munro, Contributor, Forbes, @danmunro
Dan Munro is a Contributor at Forbes where he writes on the intersection of Healthcare IT,
Innovation and Policy. His focus is broadly around those challenges, opportunities and
solutions that are fundamentally geared to scale – and have the capacity to influence our $3.5
trillion healthcare system in significant ways. (http://onforb.es/danmunro and @danmunro).
Dan graduated from the International School of Brussels before completing undergraduate
degrees in Computer Science and Communications (with a minor in Journalism) at the
University of Redlands.

5. Brought to you by
How to Provide High Quality, Low Cost
Healthcare
Best Practices And Technologies For Patients, Businesses
and Doctors

6. How to Participate
• Submit your questions in the GoToWebinar presentation
window
• Follow along and share your thoughts on Twitter at
#HWClive
• This webinar will be recorded and available for
download a few days after the webinar

7. International Consortium for
Health Outcomes Measurement
Boston, October 8, 2012

8. ICHOM Powerpoint Template.pptx8 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved
Localized prostate cancer – what is the right therapy?

9. ICHOM Powerpoint Template.pptx9 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved
Little variation in disease-specific survival rates for localized
prostate cancer
Death probably or definitely due to prostate cancer or prostate cancer treatment
Radical Prostatectomy: 12,4%
Watchful waiting: 16,9%
Source: Wilt et al., N Engl J Med 367;3 2012

10. ICHOM Powerpoint Template.pptx10 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved
Processes
Patient
experience/
engagement
Indicators
Patient
initial
conditions
(Health)
outcomes
Structure
e.g., Staff
certification,
facilities standards
PSA
Gleason Score
Surgical margin
(…)
Protocols/
guidelines
Survival
Continence
Erectile function
Anxiety
Outcomes are the 'real world' experience of patients
Example prostate cancer
Source: Porter, M. What is value in health care? Dec, 2010. NEJM.

11. ICHOM Powerpoint Template.pptx11 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved
Huge differences in functional outcomes after radical
prostatectomy between average and best hospital
Urinary incontinence Erectile dysfunction
20
15
10
5
0
6.3%
Best
hospita
l
4.5%
Average
hospital
17.1%
Prevalence, %
-74%
Active
surveillanc
e
100
80
60
40
20
0
Prevalence, %
-24%
Active
surveillanc
e
44.1%
Best
hospital
61.5%
Averag
e
hospital
81.1%
Source: Wilt et al., N Engl J Med 367;3 2012, Quality report Martini Klinik

12. ICHOM Powerpoint Template.pptx12 Copyright © 2012 by the International Consortium for Health Outcomes Measurement. All rights reserved
ICHOMWorking Group Goal: Define a minimum standard set
of outcomes we recommend all providers track
Physician leaders
Patient representatives
Tier 1
Tier 2
Tier 3
Prostate Cancer:
ICHOM Minimum Standard Set
Outcomes Measures

13. The Innovator’s Prescription:
A Disruptive Solution for Health Care
Jason Hwang, M.D., M.B.A.
@drjhwang
jhwang@gmail.com

14. Performance
Time
Performance that customers
can utilize or absorb
Pace of
Technological
Progress
Sustaining innovations
Disruptive
innovations
Disruptive innovations democratize industries through
simplicity, affordability and convenient accessibility

16. “NON-CONSUMERS”
of health care

19. Specialist Physicians
General Hospitals
Generalist Physicians
Focused, Ambu Facilities
Allied Health Professionals
Convenient kiosks
High
Low
Complexityof
diagnosisandtreatment
Time
High
Low Patients
Home, mHealth
Disruptive innovation in health care encourages new
avenues of care delivery with new caregivers

27. The Innovator’s Prescription:
A Disruptive Solution for Health Care
Jason Hwang, M.D., M.B.A.
@drjhwang
jhwang@gmail.com

29. “If you think about how healthcare is delivered, it’s on an ad hoc basis.
Someone comes into a hospital, someone comes into a pharmacy,
someone comes into a doctor. But beyond those touchpoints, the
patients are on their own. There’s no real continuity of care.”
Christopher A. Viehbacher
CEO Sanofi
Forum On Healthcare Innovation
More than 50 percent (of our MinuteClinic patients) are effectively
medically homeless. Patients at MinuteClinic did as well or better than
those treated in traditional primary care settings, yet cost was 40 to 80
percent lower than in other settings.
Andrew J. Sussman, MD
President, MinuteClinic & SVP/CMO, CVS Caremark

31. Patient Room 2020

33. • Serves ~ 55,000 Native American Indians
~10,000 in 55 remote villages
~1,400 Employees
• Patient care is integrated (inpatient, outpatient & remote)
• Team based care – no hierarchy
• Teams comprised of Docs, Nurses, Behaviorists
• Patients chose team – and can make changes
• Same day access to primary care
Nuka Model of Health Care

34. • 40% Reduction in ER
• 50% Decrease in specialty care
• 20% Decrease in primary care visits
• 35% Decrease in hospital admissions
Nuka Model of Health Care

35. • 45% Funded by Indian Health Services
• 50% “Aggressive” billing of 3rd
party payers
• 5% From Foundation/Grant money
The system we have is performing as designed. Designing a
new system is the science of process improvement – not the
science of economics. Don Berwick
Nuka Model of Health Care

36. About The Panel
Jason Hwang, M.D., M.B.A., @drjhwang
Jason Hwang, M.D., M.B.A. is an internal medicine physician who, together with Professor
Clayton M. Christensen of Harvard Business School and the late Jerome H. Grossman of
Harvard Kennedy School of Government, co-authored The Innovator's Prescription: A
Disruptive Solution for Health Care (McGraw-Hill, January 2009), the American College of
Healthcare Executives 2010 Book of the Year and recipient of the 2011 Health Service
Journal Circle Prize for Inspiring Innovation. Dr. Hwang previously co-founded and was the
Executive Director of Healthcare at Innosight Institute, a non-profit social innovation think
tank.
Jens Deerberg-Wittram, MD, President, International Consortium for Health Outcomes
Measurement, @ICHOM_Org
Trained as a physician and molecular oncologist, Jens served from 2004 to 2012 as Chief
Executive for a German 15 hospital, 4.800 beds provider organization. He has developed and
implemented valuebased corporate strategy and established a worldwide leading medical
outcomes measurement and reporting system. Prior to working in hospital management, Jens
was a project leader for BCG. He is a Senior Fellow and Faculty Member of the Harvard
Business School and lecturer in executive courses about value-based healthcare delivery.
Dan Munro, Contributor, Forbes, @danmunro
Dan Munro is a Contributor at Forbes where he writes on the intersection of Healthcare IT,
Innovation and Policy. His focus is broadly around those challenges, opportunities and
solutions that are fundamentally geared to scale – and have the capacity to influence our $3.5
trillion healthcare system in significant ways. (http://onforb.es/danmunro and @danmunro).
Dan graduated from the International School of Brussels before completing undergraduate
degrees in Computer Science and Communications (with a minor in Journalism) at the
University of Redlands.

37. How to Participate
• Submit your questions in the GoToWebinar presentation
window
• Follow along and share your thoughts on Twitter at
#HWClive
• This webinar will be recorded and available for
download a few days after the webinar

38. Thank You to Our Sponsor

39. Thanks for Joining Us
• This webinar will be available on-demand at
www.HealthWorksCollective.com.
• Stop by to learn more and share your comments.